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Early results and complications of prostatic arterial embolization for benign prostatic hyperplasia

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Abstract

Purpose

To review current knowledge on clinical outcomes and peri-operative complications of prostatic arterial embolization (PAE) in patients treated for lower urinary tract symptoms (LUTS) related to benign prostatic obstruction (BPO).

Methods

A systematic review of the literature published from January 2008 to January 2015 was performed on PubMed/MEDLINE.

Results

Fifty-seven articles were identified, and four were selected for inclusion in this review. Only one randomized clinical trial compared transurethral resection of the prostate (TURP) to PAE. At 3 months after the procedure, mean IPSS reduction from baseline ranged from 7.2 to 15.6 points. Mean urine peak-flow improvement ranged from +3.21 ml/s to +9.5 ml/s. When compared to TURP, PAE was associated with a significantly lower IPSS reduction 1 and 3 months after the procedure. A trend toward similar symptoms improvement was however reported without statistical significance from 6 to 24 months. Major complications were rare with one bladder partial necrosis due to non-selective embolization. Mild adverse events occurred in 10 % of the patients and included transient hyperthermia, hematuria, rectal bleeding, painful urination or acute urinary retention. Further comparative studies are mandatory to assess post-operative rates of complications, especially acute urinary retention, after PAE and standard procedures.

Conclusion

Early reports suggest that PAE may be a promising procedure for the treatment of patients with LUTS due to BPO. However, the low level of evidence and short follow-up of published reports preclude any firm conclusion on its mid-term efficiency. Further clinical trials are warranted before any use in clinical practice.

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Authors’ contribution

Souhil Lebdai and Romain Mathieu developed the project, collected the data and wrote the manuscript. Nicolas Barry Delongchamps, Aurélien Descazeaud, Grégoire Robert, Gregory Amouyal, Nicolas Thiounn, Marc Sapoval, Gilles Karsenty, Alain Ruffion and Alexandre de La Taille developed and reviewed the project.

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Authors and Affiliations

  1. Service d’Urologie, Centre Hospitalier Universitaire d’Angers, 4, rue Larrey, 49933, Angers Cedex 9, France

    Souhil Lebdai

  2. Urology Department, University Hospital of Cochin, 75014, Paris, France

    Nicolas Barry Delongchamps

  3. Interventional Radiology Department, Hôpital Européen Georges Pompidou, Paris, France

    Marc Sapoval & Gregory Amouyal

  4. Urology Department, University Hospital of Bordeaux, Bordeaux, France

    Grégoire Robert

  5. Urology Department, Hôpital Européen Georges Pompidou, Paris, France

    Nicolas Thiounn

  6. Urology Department, University Hospital of Marseilles, Marseilles, France

    Gilles Karsenty

  7. Urology Department, University Hospital of Lyon, Lyon, France

    Alain Ruffion

  8. Urology Department, University Hospital of Mondor, Paris, France

    Alexandre de La Taille

  9. Urology Department, University Hospital of Limoges, Limoges, France

    Aurélien Descazeaud

  10. Urology Department, University Hospital of Rennes, 35000, Rennes, France

    Romain Mathieu

Authors
  1. Souhil Lebdai
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  2. Nicolas Barry Delongchamps
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  10. Aurélien Descazeaud
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  11. Romain Mathieu
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Corresponding author

Correspondence to Souhil Lebdai.

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Conflict of interest

Souhil Lebdai, Nicolas Barry Delongchamps, Aurélien Descazeaud, Grégoire Robert, Gregory Amouyal, Marc Sapoval, Nicolas Thiounn, Gilles Karsenty, Alain Ruffion, Alexandre de La Taille and Romain Mathieu have no conflict of interest related to this topic.

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Lebdai, S., Delongchamps, N.B., Sapoval, M. et al. Early results and complications of prostatic arterial embolization for benign prostatic hyperplasia. World J Urol 34, 625–632 (2016). https://doi.org/10.1007/s00345-015-1665-6

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  • DOI: https://doi.org/10.1007/s00345-015-1665-6

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